Season 2 - Episode 3: Fireside Chat with Dr. W. Kimryn Rathmell

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Episode Guest

W. Kimryn Rathmell, M.D., Ph.D., M.M.H.C.

W. Kimryn Rathmell, M.D., Ph.D., M.M.H.C., is the 17th NCI director on December 18, 2023. She previously led the Vanderbilt University Medical Center as physician-in-chief and chair of the Department of Medicine.

Dr. Rathmell’s specialty is the research and treatment of complex and hereditary kidney cancers. She also focuses on underlying drivers of kidney cancers using genetic, molecular, and cell biology to develop interventions to improve patients’ lives. Dr. Rathmell’s research has resulted in more than 250 articles in leading peer-reviewed journals, including The New England Journal of Medicine, Nature, Proceedings of the National Academy of Sciences, and the Journal of Clinical Investigation. Read more about Dr. Kimryn Rathmell.

 

 

 

 

Show Notes

W. Kimryn Rathmell, M.D., Ph.D., M.M.H.C.
NCI Transition Career Development Workshop 
Cancer Genome Atlas 
NCI Experimental Therapeutics Program (NExT) 
NIH Faculty Institutional Recruitment for Sustainable Transformation (FIRST) Program 
V-FIRST Program 

Ad: Rising Scholars 

Renal Medullary Carcinoma (RMC) Alliance  
National Cancer Plan 

Episode Transcript

Oliver Bogler 

Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute where we explore all the different ways people fight cancer and hear their stories. I'm your host, Oliver Bogler from NCI's Center for Cancer Training.  

Today, we have a very special episode for you - a conversation with our new NCI Director, Dr. Kimryn Rathmell. My colleague Dr. Nas Zahir, Director of the Cancer Training Branch and I chatted with Dr. Rathmell at the recent Transition Career Development Workshop which Nas and her team held in January. Let’s listen. 

Nas Zahir 

It's really a pleasure to have the opportunity to speak with you, Dr. Rathmell. You are now the 17th, NCI director, and you became the 17th director in December. So congratulations. And thank you for joining us today. 

Kimryn Rathmell  

Thank you. It's a pleasure to be here. 

Nas Zahir 

So we have so many great questions that I'm sure listeners will appreciate your perspective on. To kick us off with a bit of introduction. Can you please tell us a little bit about your background? 

Kimryn Rathmell 

Sure. You know, reflecting on a question like that is is always interesting, and how do you land as the director of the NCI right? So, so my background is that I'm a physician scientist, I'm a medical oncologist. I have a PhD in biophysics, my laboratory does cancer biology, we're molecular biologists, and we're interested in everything from molecules in cancer cells that that drive tumorigenesis to the interactions of those cells, with the rest of the host, and how you might target that therapeutically. So you know, I've been working in that space for 20, 30 years, and have had the experience of doing a lot of training. So this is a great place for me to be kind of getting my feet wet here, but also running clinical trials, being a part of The Cancer Genome Atlas, doing some drug development, the NExT program, so a lot of different parts that have interacted with the NCI. And then as well, I've had a lot of years as an administrator. So put it all together. And this is sort of the perfect uniting job for me. 

Nas Zahir 

So I know, it's only been a few weeks, but what has it been like to join NCI so far? You know, as the director of NCI is reality versus what your expectations were? 

Kimryn Rathmell 

Oh, well, so it's thrilling, and it has exceeded all expectations. So, you know, I came into this because I thought it would be thrilling and it has been even more so. The people here are fantastic. The mission is just irreproachable, and the opportunities to to impact cancer from so many different directions. You know, it's, it's, I feel like a kid in a candy shop here. So I'm having really a great time. 

Oliver Bogler 

My thanks, also Dr. Rathmell, for joining us at this Transition Career Development Workshop. We  invited our workshop attendees to send in some questions. And I'd like to ask you one of those now, what measures is the NCI taking to ensure a diversity in perspective and experience among our community of NCI funded cancer investigators, and I'm thinking both those across the country that we support with the kind of mechanisms we've been talking about in this workshop, but also those in our intramural research program. 

Kimryn Rathmell 

Yeah, it's it's a big initiative across the whole spectrum. You know, first, I've been really impressed by some of my early briefings. This is this has been a topic that has come up several times initiatives that develop our training pipeline that develop our trainees to be really exceptional in whichever direction that they want to go scientifically, and our diverse recruiting practices and the curriculum and career development that exists for people who are on the staff or are in the tenured part of the NCI. That's true outside as well, you know, there, there are some tremendous programs that are NIH wide. Back when I was at Vanderbilt, I was privileged to be a part of the FIRST, we call it V-FIRST, because at Vanderbilt, everything starts with a V. The FIRST program, which is a cohort hiring program to bring diverse investigators together, so they have a peer, automatic peer group as well as institutional support. And, you know, we we worked at Vanderbilt to increase our diversity of both investigators as well as providers and staff and educators, year over year, so, and I know that that's not unique there. I think having a diverse workforce gives different perspectives. It's something that everyone recognizes brings more balance to anything that we want to do. 

Nas Zahir 

Dr. Rathmell, how did you get interested in science and medicine and cancer research? Could you share a little bit about the most important moments in your career trajectory?  

Kimryn Rathmell 

So early, my, my parents were teachers, so and my dad was a science teacher. So I was in kind of interested in science, I actually had an experience in high school, where... So I was in a very tiny, Iowa high school, and the chemistry and physics teacher, there was, you know, only one, and she was out on medical leave, and the substitute really couldn't couldn't manage it. And so two of us from the class were charged with coming over to her house learning lesson and teaching it and, and what might have been a burden actually really got me to realize how much I loved science. So that, you know, that got me to, you know, college and science and you do college and science and you think about medical school. I also worked in a nursing home. That was, again, small town, Iowa, you know, you can work on the farm, and you can work in the nursing home. And, and I really enjoyed my work there working with patients. And so putting it all together, landed as a physician scientist.  

In terms of sort of the pivotal aha moments, I'll give you two, I think, one was in medical school. So I was an MD student, before I was an MD PhD student. And I was working in a laboratory and had one of those 'waiting for the data to come out' like bated breath, you know, anticipating, you know, I don't know which way this is going to go. And, you know, finding this just fascinating result. And that aha moment was when I knew I had the bug, and I had, I had to stay in research. And so that's what caused me to take a leave of absence, get a PhD. And stay on that path that has never stopped, I still get a huge charge, when I go into the laboratory and someone wants to show me a western blot or, you know, a new plot or, you know, some new piece of data, I still find that gives me very a lot of energy. But I get energy from patients too. And the other story that I'll that I'll tell you is, you know, there have been a number of very unique patient experiences that I've had in my career that have shaped me and in terms of, you know, how I think about medicine and how I think about the healthcare system in general or, or how I think about the science that underlies their biology. I could give you a lot of different patient stories, but I'll tell you, one that I recently told, and a little bit more detailed, to a different group. Some of you heard this, but a patient had a very rare tumor type. And young guy, young African American man from rural North Carolina, who had this very rare tumor - I'll keep the story very short - introduced me to one the extreme disparities are in healthcare, and what we at the more privileged sites can do about that. But two, I don't want to use opportunity, but the opportunity that there is in rare tumors to understand discrete biologies, that can actually change the trajectory for the people who have this weird tumor type but also to understand cancer biology that is more fundamental and that particular patient, their tumor and the the experience that I had getting involved in the community around that rare tumor type really changed the way I think about cancer. 

Oliver Bogler 

Dr. Rathmell, another question from our attendees. Federal agencies across the board are facing constraints in their budget, also impacts the NCI of course. Given this particular challenge, and at the same time, the great opportunities that cancer research presents us in this at this time, how do you intend to continue to fulfill the NCI mission? 

Kimryn Rathmell 

Yeah, I wish I wish there was more, more money to go around. But the thing I know is that we will work collaboratively, we will work across boundaries, the fiscal constraints will provide some opportunity for us to think about some things differently. There are a lot of different ways that we can do the work that we do. It's not a new issue, there's always been more ideas than there is money to do them all. So this, this will be a time where we have to just really think carefully about where we want to make our investments. And and I have to say, you know, I came here because of the opportunities. And I came here because it's a unique period of time, where the White House is so invested in cancer, and so much has our back. So I'm very grateful to the President, the First Lady and Congress who in spite of what appeared to be headwinds are very consistently supportive of cancer research and of the whole mission of the NCI. So I think that we have a huge amount of things that we can do, there's never been a better time to be in cancer research than there is today. 

Nas Zahir  

NIH among many other organizations is taking a close look at the postdoc as a career stage. Based on your experience as a postdoc, and having trained and mentored so many successful postdocs, including some who are now at NIH, what would you share with those who are on this career path, or those considering it or those who are current postdocs? 

Kimryn Rathmell 

Yeah, so I think you know, the postdoc period can be the best time, you know, in a, in a scientific career, I look back on my postdoc period, and really, truly loved that period of time. Having that freedom to really dive into a project and have that be your sole focus is, you know, luxury. And, and so I want to make sure I say that, because I think there can be some, you know, concerns about the challenges that exist with being a postdoc. I think that if people are looking for a secondary level of training beyond PhD, which is sort of the time to develop your own research, the postdoc is really perfect for that. And I think it's most important that you have a good mentor, and that you have a great relationship with, with that person to be able to talk with them scientifically, but also about the career trajectory that's happening during that time. The postdoc is a very short period of time to develop an identity as a scientist. And so having a good guide for that is really important. But the other thing that I would say about being a postdoc is to trust your gut, as far as what it's leading you to about what really gets you excited, you know, where your passions are, and not to be too thwarted by people giving you advice from outside. There are a lot of different ways to be happy and successful in, in cancer research. And, and I would, you know, find the way that makes you the most happy and and can make the biggest impact discoveries, because that really is where we achieve our mission. 

Oliver Bogler 

Another question from our audience and connected to what you were just saying. Not all postdocs are interested in leading independent research teams in an academic setting. I wonder what your thoughts are about paths that lead into careers in professional science, for example, like a staff scientist or into research in the private sector, or even into science-related careers that are not research based, such as journalism or policy or law. 

Kimryn Rathmell  

I think we need smart people doing all of those jobs, right. And when I look back at the postdocs who have come through my own group, it's a big mixture. Some run their own labs in academia, many are in industry jobs. others are in government. Some are writers, some are working in more of the clinical research space. I remember actually one aha moment that I had about, you know, where we need physician scientists, because I think physician scientists tend to do this pathway and they go to do, everybody does the same thing. We did a sabbatical, my husband was invited to be on sabbatical at Novartis in Switzerland, about 10 years ago. I was doing something different, but he was working at Novartis. And he was studying, you know, the drug development space and working with a remarkable number of physician scientists. And that's when I realized, wow, you know, this is really a perfect place for people who, you know, understand the disease, or health, biology, as well as the science behind it, and how to put it all together. So, you know, I think that there are just a lot of different ways that talented people can be able to contribute. And not one is particularly more, or less than the other, they're all really important. 

Oliver Bogler 

Given that, if I may follow up, now is the NCI director, what is the role of NCI then in supporting these multiple different kinds of pathways? 

Kimryn Rathmell 

Well, I mean, I think that all of them require mentorship, all require training attention. And, you know, I think that it's our job to help make those pathways clear where we can so and, you know, I saw just a bit of this before it before I started the podcast. This session has been very, you know, broadly based, and I think that the NCI already does do a really nice job of trying to help create a lot of different opportunities for people, and help make it clear where those opportunities might lie. 

Nas Zahir 

Thank you. I'm really curious about your own research. Dr. Rathmell? And can you share any exciting stories of discovery? I'm sure there's plenty of examples. 

Kimryn Rathmell 

Sure. So we're interested in kidney cancer, which is pretty broad. And that means that I have individuals in the group who are studying individual genes that are more likely mutated in kidney cancer. And I'm gonna tell you about one story, that's really one of my favorites. It was just published earlier this year. So it's about a histone methyltransferase called SETD2. And when it's mutated, we were seeing that there's a defect in mitosis, that was hard to explain, it looked like we were getting bridging chromosomes. One common way to get bridging chromosomes is by having chromosomes that have to centromeres. And so you know, we had to learn a whole new set of assays to take a look at mitotic spreads and look at chromosomal features, and discovered that when you lose this histone methyltransferase, that we get dicentric chromosomes. They're not just dicentric, they're isodicentric centric, so they're mirror imaged chromosomes. And the biology of how that happens is super interesting. And so it's a PNAS paper by Mason at al., encourage folks to read it, but creates this opportunity for a chromosome that's going to break. And so it was a new way to understand some of the heterogeneity that happens in kidney cancer. And that aha was when we first saw our dicentric chromosomes. And when we first realized that they were palindromic, and then could really, you know, go into hyperspeed to try to figure out why, why a replication fork would make this reverse turn, so that you could get this unusual chromosomal structure. So, really enjoy enjoy this really foundational basic science, but that's so important for cancer in general, kidney cancer in our particular case. 

Oliver Bogler 

We’re going to take a quick break and then we will be back to hear more from Dr. Rathmell. 

[music] 

Nas Zahir  

The NCI’s Rising Scholars Seminar Series is a monthly seminar series we started about one year ago.  

We cover topics of all areas of cancer research, including data science and molecular mechanisms of tumor biology, as well as behavioral science. 

We invite the speakers to discuss their career path as well as talk about their research highlights. 

The goal of the NCI Rising Scholars Seminar Series is to highlight the research and the contributions that are being made by postdoctoral scholars who are funded by NCI through career development awards or fellowships, and also those who are conducting research at the NCI in the Center for Cancer Research, for example. 

Talks are the third Thursdays of every month from two to three p.m. Eastern Time.  

The presenters for the NCI Rising Scholars Seminar Series are selected by a variety of means. The first set of measures is looking to see whether there's a first author publication in the prior year. So for 2024, we examined for all of 2023. And then we ranked papers based on their number of citations as well as the field citation rate. And we also looked at  balance of demographics of the speakers, geographical location, as well as gender, race, and ethnicity to the extent possible. \

We'll put a link in the show notes to the events page for the NCI Rising Scholars Seminar Series so you can register as well as look up recordings for past webinars. 

[music] 

Oliver Bogler 

An attendee of our workshop asks, what advice do you have for investigators who work with hypothesis generating platforms, rather than traditional hypothesis testing research. These areas are within the mandate of NIH and the NCI, but study sections may be critical of this type of work, which is perhaps particularly relevant to the translational research areas. 

Kimryn Rathmell 

Yeah, I think that it's really important to realize we need all different kinds of investigation. We need traditional hypothesis testing, but but we need people who are very good at working across big datasets, for example, and using that to identify correlations or a hypothesis. I think this because we're at a training group session gets to, you know, working really closely with mentors, and being able to apply, you know, the state of the art, rigor to those kinds of analyses. Those things help study sections understand where this kind of analysis is really able to determine cause and effect. That's where I think it can be more challenging if it feels like it's, that's not clear. So helping the peer reviewers be able to see that you are able  to make that kind of a separation can certainly help. But the bottom line is that that we need all of these different kinds of research. There's just too much out there to say that there's only one kind of question that can be answered anymore. 

Nas Zahir 

Thank you. In addition to being a doctor and the scientist, you have been an advocate for research into rare forms of kidney cancer, such as renal medullary carcinoma, or RMC, which predominantly affects young adults and adolescents of African descent, who carry one copy of the sickle cell hemoglobin gene. You co founded the nonprofit organization RMC Alliance, which supports patients with this disease. Could you please tell us what led to this? 

Kimryn Rathmell 

Sure, this started with one patient. It was this patient who was 18 years old at the time he was diagnosed and showed up in my clinic. And really epitomizes this, this cancer, which traditionally hits - this is renal medullary carcinoma - hits young people with sickle cell trait, typically between the ages of 10 and 25. So it falls into the cracks in a lot of different ways. It's traditionally hitting people from minoritized backgrounds, obviously, it often hits families who are who come from more impoverished areas, it hits between pediatric and adults. I remember just distinctly with this particular patient, sitting with his mother and talking about all of the different ways that he was falling, had fallen through the cracks and how much that hurt on top of the terrible diagnosis that that he had anyway. And that led to, you know, kind of pushing to make sure that we knew more about how to treat this cancer. I'm an academic publishing a paper and started a, you know, a snowball effect of bringing more and more people on board. What I will tell you about is the great importance of advocacy in rare tumor types. So, early on, in this snowball effect, I met a couple of advocates. One in particular, I met through Twitter now X  who had heard that I was publishing on this topic and she was passionate about it. And she helped to start to create networks so that as people were diagnosed, they were getting referred either to me or to one of the other handful of people and who were studying, interested in this cancer type. And we decided to host a meeting. And we hosted a small think tank meeting. We brought in two other advocates as well. And that meeting was one of those sort of pivotal, everybody on the same page saying we need grants that support research in this space. We need clinical trials that are dedicated to this we need a network so that we can very rapidly get patients to the right place with the right diagnosis at the right time. We need educational programs and and we need to do it all together. You know, maybe it was the combination of people, but I think it was seeing where suddenly we could make a big difference. And that's what led to the start of the RMC Alliance, which is sort of the glue that brings all of the people together. Really, it was, you know, not anything I ever expected in my career to go and do. And, you know, in truth, this is a rare disease. And I have not gone on to see that many more patients like this. But, I'm a part of that community and can be a part of ensuring that that community stays healthy so that when patients are diagnosed with renal medullary carcinoma, they can land in the right place. And I was so delighted to see the attention that it's getting at the NCI. I was literally on a call earlier today about rare tumors and, you know, listing rare tumors and renal modularity popped right up there. So it may, it may be rare, but it's now on the tip of people's tongues, and it's something that the awareness is going to make a huge difference. 

Oliver Bogler 

Dr. Rathmell, you showed a deep commitment to mentoring and developing the next generation of physician scientists. Our audience asks, how committed is the NCI to the career development and support of these vital members of our research community? 

Kimryn Rathmell 

Well, so I'll speak about me first. So I'm the daughter of two teachers. I grew up hearing about curriculum development and individual person development and talent development in general, all the way through my upbringing. So I think that is part of why I feel very invested in this. I later once I was a, an assistant professor, on my own, got to be involved, of course, in running my laboratory, but also in training programs. And that the first training program that I was most involved in was the MD/PhD training program, which hosts about, this was at UNC Chapel Hill, about 100 students in total, across this whole spectrum. And this sort of lifecycle of an MD/PhD student was really fascinating to me from, you know, a 22 year old headed, you know, toward, you know, what laboratory? What kind of science do they want to do to heading into the clinic and learning how they're going to be a doctor? And how is it all going to fit together? And where are they going to match for residency? And what are they going to do with the rest of their lives? And I found that, that whole arc to be just fascinating. And it's career, but it's also personal, you know, over that eight years of training, seven, eight years of training, I think we aim for like a 7.2. Right? Is, you know, 22 to 30. People are getting married people have kids, they you know, get dogs and they have life events that happen. And being a part of that was also incredibly rewarding and fulfilling to me. Okay, so that's me. So I think other people who get invested in training, find those same elements to be very compelling. The NCI has, for decades had a great investment and training from everywhere from middle school to mid career, right, we all need training. And so I think there shouldn't be any worry that the NCI isn't fully invested in ensuring that everyone from people to programs find their path. 

Nas Zahir 

So a little bit more of a personal question, what are some of the things you like to do when you're not seeing patients or doing research or leading the NCI? 

Kimryn Rathmell 

I really like to do puzzles. So that probably fits with leading the NCI. The NCI is one big puzzle. I really like puzzles that are challenging and involve actually taking apart a lot of knots. So that that fits very well as well. So, you know, if it's just me on a weekend, that's, that's the thing I would love to do most. I'm also an avid reader. I really enjoy sitting down with a good book. I enjoy writing as well. And so I write as an outlet too, and then finally, I am a big fan of basketball, college basketball in particular. I watched a lot of basketball. I don't play basketball anymore. But I enjoy watching the game. And  actually thinking about often how how much basketball serves as a good analogy for a lot of what we do in science. So, I tend to write about that. So you, you may see a little bit of basketball analogy in some of my writing because I like the connections to teamwork and to you know, exceptional plays and to the the role of the referee and the role of the crowd and the role of the coach. Right. So, all of that fits in. 

Oliver Bogler 

Dr. Rathmell, we've heard that you're a proponent of the National Cancer Plan, and that everyone has a role in ending cancer as we know it. Our audience asks, how can they be involved in the National Cancer Plan and contribute to its eight goals? 

Kimryn Rathmell 

Yes, so I am a big fan of the Cancer Plan. I think that it really articulates well what we've been wanting to do and in the cancer space or have been doing for decades, but putting it on one concise eight points. The part that I like most about it is the everyone has a role as you as you touch on. And, you know, what does that mean? First, it means that there's a place for everyone along that continuum of cancer from preventing cancer from happening to early detection and screening, treatment, and survivorship. So that continuum is well covered. But the part I like most about the everyone plays a role is that it's not just scientists, and it's not just the NCI it's not just oncologists, either, it's other providers in the community. And it's every patient and family member. And it's every person, right? It's personal responsibility for taking on the screening so that we can have early detection or being a personal health advocate so that we can prevent having cancer if, possible, right. So I like that whole part of it. I would encourage everyone to read the plan, or at least the bullet point, one page summary, because it's very, very comprehensive, even though it's brief. And it's a great tool for fostering collaboration, for identifying gaps and inspiring some ideas as well. So I think the potential of the cancer plan depends on how you want to use it. But I really encourage everyone to find their space in that plan. 

Nas Zahir 

Dr.  Rathmell, what are you most excited about in your new role as NCI director, and what do you see as the main challenges? 

Kimryn Rathmell 

Well, I'm excited about everything. I'm excited about what we can accomplish together. And I'm excited about opening up the some of the spaces for people to just get involved. Challenges, I think, the challenges. This is a great forum, because part of the challenge is around workforce. I think it's a place where we need more people, more smart, talented people than ever before. And, and it's a place to work that is motivational and inspiring. And I really encourage people to take that on. I think that, you know, if there are challenges around resources, I think we can manage them. We're all in this together and the opportunities are really endless. So I think that the benefits far outweigh any of the challenges. 

Oliver Bogler 

Dr. Rathmell last question from our attendees. What advice would you give someone who is soon to be graduating college and is thinking about a career in cancer research? 

Kimryn Rathmell   

So this is a great time to be in cancer research. Whatever someone is interested in, there are new opportunities and new technologies, new datasets and new ways of thinking, all of which can have real time impact in cancer. So I actually have a niece right now graduating from college and I'm strongly encouraging her to think about looking at a career in cancer research and would do the same for anyone who who wants to think about it. I think there are just so many opportunities. I've trained lots of people in this cancer research journey . So at that period of time, from college to the next step, you know, the world is just your oyster. And there's so many ways that you can contribute and have just a wonderful career. So we need all that skill, and talent, and we need to focus it on cancer because we need to make a big difference there. 

Nas Zahir  

Is there anything else that you'd like to share with those listening that you haven't had an opportunity to share yet? 

Kimryn Rathmell 

Well, first, I would just say, thanks for having me. This is a thrill for me to be a part of talking to people right at that K award. I think that's just one of the most fun sweet spots in the in the cancer journey. So I wish I could be talking to all of you in person, but thank you for letting me be here. I hope it is clear, I'm really excited to be stepping into this role as the NCI director. And really, I'll just reinforce with the the last question asked, which is, you know, why, why do a job in cancer research, which is, there just is no better time there is no better mission. There's no better way to take this kind of intellectual curiosity and put it to great use than to work in the cancer space. So just really thrilled to be here. 

Oliver Bogler 

I do have one last question, Dr. Rathmell. And as a fellow dog lover, I wonder, can you tell us more about Princess Dave? 

Kimryn Rathmell 

Princess Dave! Yeah, so Princess Dave is a German Shepherd mix. We got her, adopted her about seven years ago. She's about 12 now. At a German Shepherd rescue, although billed as a Dutch Shepherd, and my husband wanted a dog named Dave. We had we had just moved from North Carolina to Tennessee and his leaving his friend, his running buddy Dave. And so he wanted a running dog named Dave. So that part's a long story. But But this dog was already named Princess. And when we tried to shift her to Dave that didn't fly, so she became Princess Dave, which is a great name. Because some people call her Princess some call her Dave. We call her PD and P Diddy and, you know, whatever, whatever we, you know, kind of suits the mood of the day, but she's a incredibly sweet German Shepherdish dog with gigantic ears.  

Oliver Bogler 

That sounds great. Thank you so much for joining us, Dr. Rathmell for this conversation. 

Kimryn Rathmell  

Oh, thank you very much. It's been a pleasure. 

Oliver Bogler 

That’s all we have time for on today’s episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests. 

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